Increased risk of non-insulin dependent diabetes mellitus at low plasma
vitamin E concentrations: a four year follow up study in men.

OBJECTIVE--To investigate whether low vitamin E status is a risk factor
for incident non-insulin dependent diabetes mellitus. DESIGN--Population
based follow up study with diabetes assessed at baseline and at four years.
SETTING--Eastern Finland. SUBJECTS--Random sample of 944 men aged 42-60
who had no diabetes at the baseline examination. INTERVENTION--Oral glucose
tolerance test at four year follow up. MAIN OUTCOME MEASURES--A man was
defined diabetic if he had either (a) a fasting blood glucose concentration
> or = 6.7 mmol/l, or (b) a blood glucose concentration > or = 10.0
mmol/l two hours after a glucose load, or (c) a clinical diagnosis of
diabetes with either dietary, oral, or insulin treatment. RESULTS--45
men developed diabetes during the follow up period. In a multivariate
logistic regression model including the strongest predictors of diabetes,
a low lipid standardised plasma vitamin E (below median) concentration
was associated with a 3.9-fold (95% confidence interval 1.8-fold to 8.6-fold)
risk of incident diabetes. A decrement of 1 mumol/l of uncategorised unstandardised
vitamin E concentration was associated with an increment of 22% in the
risk of diabetes when allowing for the strongest other risk factors as
well as serum low density lipoprotein cholesterol and triglyceride concentrations.
CONCLUSIONS--There was a strong independent association between low vitamin
E status before follow up and an excess risk of diabetes at four years.
This supports the theory that free radical stress has a role in the causation
of non-insulin dependent diabetes mellitus.

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